Depression and Sexual Health

Written by Dale Kiefer
| Published on March 29, 2012Medically Reviewed by George Krucik, MD

Depression affects virtually every aspect of a person’s life, and the sex life is no exception. Learn how depression affects sex and what you can do about it.

Depression affects virtually every
aspect of a person’s life, and his or her sex life is no exception. As they
say, the brain is the most important sex organ of all. Since depression is a
disorder centered in the brain, it’s no wonder sexual dysfunction and
depression are often linked together.

By definition, people with
depression experience a reduction in, or absence of, pleasure or interest in
activities that formerly interested them or gave them pleasure. While this can
refer to simple things, like engaging in hobbies, interest in sex and enjoyment
of sexual relations are also likely to be affected by depression. And, needless
to say, when a person is no longer interested in sex, or is unable to
experience pleasure, the person’s sexual partner will also be affected.

Unfortunately, depression often
strains relationships, which only makes sexual relations more challenging.

Gender, Depression & Sex

The loss of ability to experience
pleasure may lead to a decreased desire for sexual relations. This loss of
libido is not uncommon.

In men, loss of libido may be
linked to erectile dysfunction. Sexual activity depends on a working
relationship between the body and mind. Depression may interrupt this
relationship. Men with depression may experience impotence, which can trigger a
vicious cycle of sexual performance anxiety, followed by renewed erectile
dysfunction, which only makes performance anxiety worse.

Depression and sexuality may be
intimately entwined in other ways, as well. For example, victims of sexual
abuse, or sexual violence, are more likely to experience serious depression.
Research suggests that some depressed people are more likely to engage in risky
sexual behavior, such as having unprotected sex, or engaging in sex with
multiple partners. Of course, this type of behavior puts a person at risk of
contracting any number of sexually transmitted diseases.

Menopause offers another example
of the link between depression and sexuality. Women undergoing menopause are
more prone to developing depression, while changes in sexual desire and
activity are also common among this group. Some of the physical and hormonal
changes during menopause can undermine a woman’s libido and her ability to
engage in pleasurable sex.

Depression & Sexual Dysfunction

Experts estimate that about 70
percent of people with depression will experience sexual dysfunction. Men may
experience erectile dysfunction (impotence), a decline in sexual desire, and
difficulties with ejaculation. Among men, the rate of sexual dysfunction is
estimated to be 23-50 percent.

Among depressed women, the rate of
sexual dysfunction is estimated to be as high as 33-90 percent. Depression related
sexual dysfunction among women usually takes the form of difficulties with
becoming aroused (such as uncomfortable vaginal dryness), and an inability to
achieve orgasm or delayed orgasm.

Sometimes the
Solution Is Part of the Problem?

Modern antidepressant
medications—primarily of the selective serotonin reuptake inhibitor (SSRI)
class—have transformed depression treatments. These drugs are often effective
at relieving the symptoms of depression, with the added benefit that they tend
to have fewer side effects than older medications, such as the tricyclic
antidepressants.

Modern antidepressant medications
have helped to bring major depression out of the shadows and into the light.
For better or worse, their widespread popularity has helped bring attention to
depression as a treatable illness, and has played a role in removing the stigma
long associated with this common psychiatric disorder.

But when it comes to sexual
health, modern antidepressants (especially SSRIs) are also all-too-often part
of the problem for the patients who take them, because sexual dysfunction is a
common side effect of these drugs. The most common sign of this side effect is
an adverse effect on sexual desire, and delayed or absent orgasm, among both
men and women. Men may also experience difficulty achieving and maintaining an
erection due to this side effect. Higher doses of medication tend to be linked
to greater sexual dysfunction.

From the perspective of the
treating physician, the biggest problem presented by this side effect is that
it may lead patients to discontinue therapy. This can cause patients to relapse
into depression before successful treatment can be achieved. If you or someone
you know has been prescribed antidepressant medication, it’s crucial that you discuss
such concerns with your doctor before stopping medication.

Side effects such as sexual
dysfunction can often be addressed by adjusting the dosage or switching to
another, similar medication. Some antidepressant drugs are associated with
fewer sexual side effects than others. It can also be dangerous to abruptly
stop taking certain antidepressants, for a number of reasons.

The treating physician may also
recommend medication that can help men achieve and maintain an erection. Drugs
such as sildenafil (Viagra) and tadalafil (Cialis) may help men counteract the
sexual dysfunction associated with SSRI use.

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